A President Felled by an Assassin and 1880’s Medical Care

Garfield lingered on his deathbed for 80 days, attended by doctors who disagreed on his treatment, and by his wife and daughter. Even Alexander Graham Bell tried to help locate the bullet that was lodged in the president.Credit
National Museum of Health and Medicine, Armed Forces Institute of Pathology

WASHINGTON — Three vertebrae, removed from the body of President James A. Garfield, sit on a stretch of blue satin. A red plastic probe running through them marks the path of his assassin’s bullet, fired on July 2, 1881.

The vertebrae form the centerpiece of a new exhibit, commemorating the 125th anniversary of Garfield’s assassination. The exhibit also features photographs and other images that tell the story of the shooting and its aftermath, in which Garfield lingered on his deathbed for 80 days. Located at the National Museum of Health and Medicine, on the campus of the Walter Reed Army Medical Center, the exhibit opened on July 2 and will close, 80 days later, on Sept. 19.

Garfield was waiting at the Baltimore and Potomac Railroad Station in Washington, about to leave for New England, when he was shot twice by the assassin, Charles J. Guiteau.

The first bullet grazed Garfield’s arm, said Lenore Barbian, anatomical collections curator for the museum. But the second struck him in the right side of the back and lodged deep in the body.

At the time, however, without the benefit of modern diagnostics, Garfield’s doctors could not determine the location of the bullet. “Trying to understand its pathway became their primary concern,” Dr. Barbian said.

At least a dozen medical experts probed the president’s wound, often with unsterilized metal instruments or bare hands, as was common at the time.

Sterile technique, developed by the British surgeon Joseph Lister in the mid-1860’s, was not yet widely appreciated in the United States, although it was accepted in France, Germany and other parts of Europe. Historians agree that massive infection, which resulted from unsterile practices, contributed to Garfield’s death.

The exhibit describes how the president’s fluctuating medical condition became a national obsession in the summer of 1881. His doctors issued daily medical briefings, which were rapidly disseminated by telegraph and published in newspapers across the country. In response, the White House received letters by the bushel basket.

“One man suggested that they turn the president upside down and see if the bullet would just fall out,” Dr. Barbian said.

Photo

Two bullets hit President Garfield. One grazed his arm; the second pierced his first lumbar vertebra, above.Credit
National Museum of Health and Medicine, Armed Forces Institute of Pathology

The exhibit also includes an image of the metal detector designed by Alexander Graham Bell to search for the bullet. It was composed of a battery and several metal coils positioned on a wooden platform and was connected to an earpiece.

Jeffrey S. Reznick, senior curator at the museum, said the device was designed to create an electromagnetic field, which would be disrupted in the presence of a metal object. The disruption would cause the device to emit a clicking sound through the earpiece.

“Electricity and magnetism were just being appreciated as ways to explore the body’s interior,” Dr. Reznick said.

Bell’s invention failed on two occasions to pinpoint the bullet’s location. Historians say this may have been because the device picked up metal coils in the president’s mattress, or because Bell searched only on the right side of Garfield’s body, where the lead physician, Dr. Doctor Willard Bliss — Doctor was his given name — had come to believe the bullet was lodged.

In early September, the president was moved from the White House to a cottage in Elberon, N.J., on the shore.

Also in the exhibit is an image of the president on his deathbed, lying on his back draped in a sheet and surrounded by friends and family, including his wife, Lucretia, and his daughter, Mollie. Garfield died in New Jersey on Sept. 19, 1881.

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Photographs of Drs. Daniel S. Lamb and Joseph J. Woodward, who led the autopsy, are shown in the exhibit as well. Dr. Lamb and Dr. Woodward were affiliated with the Army Medical Museum in Washington, which later became the National Museum of Health and Medicine.

At the autopsy, it became evident that the bullet had pierced Garfield’s vertebra but missed his spinal cord. The bullet had not struck any major organs, arteries or veins, and had come to rest in adipose tissue on the left side of the president’s back, just below the pancreas.

Dr. Ira Rutkow, a professor of surgery at the University of Medicine and Dentistry of New Jersey and a medical historian, said: “Garfield had such a nonlethal wound. In today’s world, he would have gone home in a matter or two or three days.”

In addition to causing sepsis by probing the wound with unsterile hands and instruments, Garfield’s doctors did him a disservice by strictly limiting his solid food intake, believing that the bullet might have pierced his intestines, said Dr. Rutkow, the author of “James A. Garfield,” a book in the American Presidents Series.

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Credit
National Museum of Health and Medicine, Armed Forces Institute of Pathology

In mid-August, the doctors insisted that Garfield be fed rectally, and he received beef bouillon, egg yolks, milk, whiskey and drops of opium in this manner.

“They basically starved him to death,” said Dr. Rutkow, noting that the president lost over 100 pounds from July to September.

Garfield’s assassination occurred at a time of transition in American medicine. There was little standardization of medical practice, and various sects — including homeopaths and allopaths, who took opposite approaches to treatment — competed for patients.

Behind the scenes, relations between Garfield’s physicians were acrimonious, historians say. While the head physician, Dr. Bliss, released optimistic reports to the press, his rivals, including Dr. Silas Boynton, repeatedly leaked negative — and ultimately more truthful — information. (Dr. Bliss was an allopath and Dr. Boynton was a homeopath, which partly accounts for their rivalry.)

Dr. Rutkow said that sterile practice was widely accepted in the United States by the early 1890’s. X-rays, which would also have been helpful to the president, were discovered in the 1890’s as well.

The Garfield exhibit is on display alongside the museum’s permanent Civil War exhibit, which includes the bullet that killed President Abraham Lincoln and fragments of his skull, as well as bone saws, artificial limbs and various other Civil War artifacts. The museum also holds the spleen, the brain and most of the skeleton of Garfield’s assassin, Guiteau, although these artifacts are not part of the current exhibit.

Sarah Vowell, the author of “Assassination Vacation,” which explores the assassinations of Lincoln, Garfield and President William McKinley, says Garfield’s vertebrae were passed around to the jurors at Guiteau’s trial.

The assassin’s lawyers tried to argue that their client was not guilty by reason of insanity. The defense was unsuccessful, and he was hanged on June 30, 1882.

Guiteau himself repeatedly criticized Garfield’s doctors, suggesting that they were the ones who had killed the president.

A picture in Science Times on Tuesday with an article about a new exhibit at the National Museum of Health and Medicine in Washington, showing the medical care given President James A. Garfield after he was shot by an assassin in 1881, was provided by the museum in reverse and printed that way. As the article noted, the second bullet pierced Garfield’s first lumbar vertebra, crossing from right to left — not left to right, as shown in the picture.

A version of this article appears in print on , on Page F5 of the New York edition with the headline: A President Felled by an Assassin and 1880’s Medical Care. Order Reprints|Today's Paper|Subscribe